WEBVTT - Senate Passes $550 Billion Infrastructure Plan in Win for Biden 0:00:01.800 --> 0:00:04.440 This is Bloomberg Business Week. I'm Carol Masser and I'm 0:00:04.480 --> 0:00:07.280 Bloomberg Quick Takes Tim Stanovk. We're here every day bringing 0:00:07.320 --> 0:00:09.799 you the latest news from the world to business and finance, 0:00:09.840 --> 0:00:13.680 plus technology, politics, economics, all furnishing the power of Business 0:00:13.680 --> 0:00:17.119 Week reporters and editors, not to mention our journalists and 0:00:17.120 --> 0:00:20.000 analysts in more than one twenty countries. You can download 0:00:20.000 --> 0:00:23.239 Bloomberg Business Week and iTunes, SoundCloud, or Bloomberg dot Com. 0:00:23.400 --> 0:00:25.200 You can also listen to our radio show at two 0:00:25.200 --> 0:00:27.880 pm Eastern Time on Bloomberg Radio, or watch us on 0:00:27.920 --> 0:00:32.760 YouTube search Bloomberg Clovel News. Hospitals generally across the US, 0:00:32.800 --> 0:00:35.800 they are parceling out beds for COVID patients, hunting for 0:00:35.880 --> 0:00:38.520 doctors and nurses as a delta variant sweeps from coast 0:00:38.520 --> 0:00:41.800 to coast. Let's get an update though on COVID. Let's 0:00:41.800 --> 0:00:45.240 bring in Dr Ty Glackwin, his director of cardiovascular analytics 0:00:45.240 --> 0:00:47.960 at Providence Sant Joseph's Health. You might recall we've talked 0:00:47.960 --> 0:00:49.960 to many of their team over the last year and 0:00:49.960 --> 0:00:51.720 a half. It is one of the largest health care 0:00:51.760 --> 0:00:55.400 systems in the US massive and it also has more 0:00:55.400 --> 0:00:59.600 than fifty hospitals in seven states, lots of clinics, lots 0:00:59.600 --> 0:01:01.560 of care of ours, and they were home to the 0:01:01.560 --> 0:01:05.240 first confirmed COVID case back in early Dr Gluckman joining 0:01:05.280 --> 0:01:07.800 us on the phone in Portland, Oregon. Dr Gluckman, nice 0:01:07.840 --> 0:01:10.560 to have you here, Um, Bloomberg Radio, how are you. 0:01:11.680 --> 0:01:13.360 I'm great. It's a pleasure to be with you. I 0:01:13.360 --> 0:01:15.600 hope you're staying safe and doing well. We are. We 0:01:15.680 --> 0:01:17.959 are trying and trying to, you know, assess all of 0:01:17.959 --> 0:01:21.479 the headlines that are out there. Um, you know, you guys. 0:01:21.560 --> 0:01:23.920 What's interesting is have done a study recently, and I 0:01:23.959 --> 0:01:25.440 think this is something that we need to bring to 0:01:25.480 --> 0:01:29.440 everybody's attention about what's happening to some patients. And we're 0:01:29.480 --> 0:01:31.480 not talking about COVID patients. Why don't you get us 0:01:31.520 --> 0:01:34.640 up to speed on that. Yeah, So, for many of 0:01:34.720 --> 0:01:37.600 us in the early surge in the spring of last year, 0:01:37.600 --> 0:01:43.000 in we're observing the hospitalization rates, emergency department rates, people 0:01:43.040 --> 0:01:46.200 coming to the hospital. We're wayed down. And we've seen 0:01:46.319 --> 0:01:48.560 several reports that have come out in the United States 0:01:48.720 --> 0:01:52.920 and outside the United States suggesting a reduction in hospitalization 0:01:53.000 --> 0:01:57.440 rates and even heightened mortality death rates for people hospitalized. 0:01:57.600 --> 0:02:01.320 So we sought to better understand the cross are six 0:02:01.400 --> 0:02:04.800 of our states and fifty one hospitals across a broad 0:02:04.920 --> 0:02:08.680 range of different conditions. What were the hospitalization rates looking like, 0:02:08.840 --> 0:02:11.440 What were the death rates looking like, both in the 0:02:11.480 --> 0:02:15.320 spring surge of as well as the fall surge late 0:02:15.400 --> 0:02:20.200 this past fall, and what what did you find? So, 0:02:20.760 --> 0:02:23.680 you know, a bunch to the disappointment, We saw similar 0:02:23.720 --> 0:02:27.560 things that had been observed previously, so in the spring surge, 0:02:27.680 --> 0:02:32.200 and this is compared to a period of time pre pandemics. 0:02:32.560 --> 0:02:36.240 We saw that our unplanned hospitalizations, so these are people 0:02:36.280 --> 0:02:40.240 coming in for urgent conditions, and patients with COVID nineteen 0:02:40.280 --> 0:02:43.000 were excluded from the studies, so these are unrelated to 0:02:43.080 --> 0:02:50.359 COVID nineteen hospitalizations. Unplanned hospitalizations declined very abruptly, dropping by 0:02:50.400 --> 0:02:54.240 as much as fifty five zero percent from a period 0:02:54.440 --> 0:02:59.120 of early March through mid May, and then there was 0:02:59.160 --> 0:03:02.080 a rise back up again beyond that initial surge, but 0:03:02.200 --> 0:03:04.240 not to the same rates that the otherwise would have 0:03:04.240 --> 0:03:07.640 been in terms of hospitalizations falling again in a fall 0:03:07.680 --> 0:03:12.400 period from late October through late December as well. And 0:03:12.480 --> 0:03:16.639 so we observed that during periods of surge of COVID nineteen. 0:03:17.160 --> 0:03:22.200 We saw that hospitalizations across our different states fell precipitously 0:03:22.320 --> 0:03:25.880 during both periods of time. In addition to this, we 0:03:25.960 --> 0:03:30.200 looked at mortality rates adjusted in hospital death rates for 0:03:30.280 --> 0:03:33.400 people who are hospitalized during those periods of time and 0:03:33.480 --> 0:03:37.760 those rows during both periods. So while hospitalization rates were falling, 0:03:38.200 --> 0:03:40.920 there was an increase in the death rates for people 0:03:41.080 --> 0:03:44.640 during that initial spring and again in that false surge 0:03:44.640 --> 0:03:48.560 as well. Very disheartening across the different states and across 0:03:48.600 --> 0:03:51.400 a broad range of conditions that we evaluated. And so 0:03:51.480 --> 0:03:55.520 the conclusion here is that essentially people aren't getting the 0:03:55.600 --> 0:03:58.839 care that they need in hospitals, either putting it off 0:03:58.920 --> 0:04:02.400 or ignoring things, whether out of concerns about being in 0:04:02.480 --> 0:04:05.400 hospitals or what have you, I'm assuming, and so as 0:04:05.400 --> 0:04:09.840 a result, that is leading to potentially complications in their health, 0:04:10.040 --> 0:04:14.720 and it sounds like also leading to death. Yeah, So 0:04:14.800 --> 0:04:17.599 there are a bunch of potential takeaways from this, but 0:04:17.720 --> 0:04:19.560 one of which is is that there has been a 0:04:19.600 --> 0:04:24.720 spillover effect during the pandemic. And while we can't definitively 0:04:24.800 --> 0:04:28.640 determine why people stayed away or why people died at 0:04:28.640 --> 0:04:31.520 a higher rate. One of the biggest concerns that are 0:04:31.560 --> 0:04:34.200 to take away from this is that patients, out of 0:04:34.240 --> 0:04:38.599 concern of potentially contracting infection with stars Coby two getting 0:04:38.680 --> 0:04:43.680 COVID nineteen, that they stayed away from hospitals, from emergency departments, 0:04:43.720 --> 0:04:48.400 from clinics, and therefore when they ultimately presented for these urgent, 0:04:49.440 --> 0:04:53.520 unplanned hospitalizations, they were that much sicker when they ultimately 0:04:53.520 --> 0:04:57.120 were hospitalized, and that accounts for their higher mortality rate. 0:04:57.960 --> 0:05:02.000 How are you do in an outreach to your community. 0:05:02.000 --> 0:05:06.320 Obviously they are patients, are doctors who have patients um 0:05:06.960 --> 0:05:10.880 that they know maybe are in compromise states or could be. 0:05:11.400 --> 0:05:14.560 How are you reaching out to your community to tackle this. 0:05:16.120 --> 0:05:18.880 It's a great question, and it was important during the 0:05:18.960 --> 0:05:21.280 spring sturge. It's important the false surge. But I can 0:05:21.320 --> 0:05:24.000 tell you we weren't anticipating when we initially designed the 0:05:24.000 --> 0:05:26.640 study that we'd be sitting in a surge today going 0:05:26.680 --> 0:05:29.160 on and across the United States, and so I think 0:05:29.160 --> 0:05:34.440 it's really important to unambiguously emphatically let our patients know 0:05:34.680 --> 0:05:38.479 that our clinics, are emergency departments, are hospitals, are safe 0:05:38.520 --> 0:05:41.840 places to receive care, and so in patients who are 0:05:41.839 --> 0:05:44.800 concerned about their health, they should not hesitate to contact 0:05:44.880 --> 0:05:49.719 emergency medical services, call, come to their clinics, reach out 0:05:49.720 --> 0:05:52.760 to their clinicians, come to the emergency department, because the 0:05:52.839 --> 0:05:56.360 consequences of delaying their care can be quite significant. I 0:05:56.400 --> 0:05:58.799 want to get back to Dr Ty Gluckman. He's director 0:05:58.800 --> 0:06:02.000 of the Center for Cardiovasular Analytics at Providence St. Joseph's 0:06:02.000 --> 0:06:05.080 Health with us on the phone from Portland, Oregon. You know, 0:06:05.120 --> 0:06:07.279 it's interesting, Dr Gluckman, this is something that we have 0:06:07.320 --> 0:06:10.560 talked about with many members of the medical community. Throughout 0:06:10.560 --> 0:06:14.599 the pandemic. There was that concern and understandably as hospitals 0:06:14.600 --> 0:06:19.400 were overwhelmed that they had to prioritize COVID patients. How 0:06:19.440 --> 0:06:24.719 are hospitals managing both COVID patients and regular routine medical 0:06:24.760 --> 0:06:28.200 treatments at this point. Are you finding where there are 0:06:28.240 --> 0:06:31.599 areas of surge that you can't manage both, or have 0:06:31.720 --> 0:06:34.240 hospitals figured out a way to do both at the 0:06:34.279 --> 0:06:37.640 same time. Yeah, it's a great question, and I think 0:06:37.680 --> 0:06:40.640 early on we were struggling. Certainly during the initial spring 0:06:40.680 --> 0:06:44.400 surgeon I will say across all of our hospitals. While 0:06:44.440 --> 0:06:47.720 we've seen in our communities rising CAITH counts, I think 0:06:47.720 --> 0:06:50.640 we're doing a great job of balancing both and making 0:06:50.640 --> 0:06:53.880 sure that patients feel safe if they're dealing and struggling 0:06:53.880 --> 0:06:56.880 with COVID nineteen to receive the appropriate care they need 0:06:57.200 --> 0:06:59.400 if they need it in our emergency departments are in 0:06:59.440 --> 0:07:03.400 our hospital. But similarly, for those individuals that are not 0:07:03.520 --> 0:07:07.000 dealing with COVID Night Team, but are dealing with critical 0:07:07.000 --> 0:07:10.520 illness urgent medical conditions, they should feel very comfortable in 0:07:10.560 --> 0:07:13.440 seeking out care. We found ways to be able to 0:07:13.640 --> 0:07:16.320 provide that care in the outpatient setting and certainly in 0:07:16.320 --> 0:07:19.080 our hospitals and emergency departments as well. Yeah, it does 0:07:19.120 --> 0:07:21.320 feel like you know, we said man I said so 0:07:21.360 --> 0:07:23.200 many times, we didn't have the playbook right, None of 0:07:23.240 --> 0:07:26.720 us had the playbook pre pandemic, despite warnings that have 0:07:26.800 --> 0:07:28.600 been out there for years. It's something like this would 0:07:28.640 --> 0:07:32.920 ultimately come. Um, how has that playbook filled up in 0:07:32.960 --> 0:07:35.040 your view that we are in a better position even 0:07:35.080 --> 0:07:37.520 with these new surges and what other new surges may 0:07:37.520 --> 0:07:40.840 come as a result of future variants. How is that 0:07:40.880 --> 0:07:45.520 playbook better equipped at this point? Yeah, I believe that 0:07:45.600 --> 0:07:48.400 early on we were struggling even in things like having 0:07:48.440 --> 0:07:51.560 adequate amounts of PPE, making sure that we had ventilators 0:07:51.600 --> 0:07:55.560 for those patients who had lung related conditions that warranted it. 0:07:55.960 --> 0:07:58.240 I think today now we're just trying to make sure 0:07:58.280 --> 0:08:01.320 that we are prioritizing here for those people who need 0:08:01.320 --> 0:08:04.480 it most in our emergency departments and in our hospitals. 0:08:04.920 --> 0:08:07.240 I want to reaffirm that you know, our hospitals and 0:08:07.280 --> 0:08:10.880 emergency departments are safe places to receive care, and we 0:08:10.920 --> 0:08:14.360 have the ability to care for people who need care 0:08:14.520 --> 0:08:18.000 in those different specific settings. UM. I think also we 0:08:18.120 --> 0:08:20.840 figured out a way to be able to have our 0:08:20.920 --> 0:08:25.120 clinical teams UH and the range of different clinicians and 0:08:25.160 --> 0:08:28.280 care team members involved, whether it's in the outpatient setting, 0:08:28.640 --> 0:08:33.400 leveraging where appropriate virtual care, tell health strategies in the hospital, 0:08:33.440 --> 0:08:35.800 making sure that we're adequately resourced to be able to 0:08:36.360 --> 0:08:39.720 attend to all the needs patients have. So I feel 0:08:39.720 --> 0:08:41.720 like we're at a very good place to be able 0:08:41.720 --> 0:08:44.680 to deliver the care that's needed, whether it's related to 0:08:44.720 --> 0:08:47.560 COVID nineteen or it's an unplanned need to come to 0:08:47.600 --> 0:08:50.720 the hospital for something completely unrelated to COVID. Night Team 0:08:50.880 --> 0:08:52.679 I Almoso curious, you know, as you talk about this 0:08:52.720 --> 0:08:55.280 study that you did, UH and people who are maybe 0:08:55.280 --> 0:08:59.359 putting off, you know, coming into hospitals for different reasons, 0:08:59.360 --> 0:09:02.400 how much of kind of routine treatment is still down 0:09:02.520 --> 0:09:06.920 from where it was at pre pandemic levels. So I 0:09:07.240 --> 0:09:09.559 think our capacity to be able to accommodate a lot 0:09:09.600 --> 0:09:13.440 of basic preventive care and then usual chronic medical care 0:09:13.920 --> 0:09:15.680 is back up to where we need it to be. 0:09:16.240 --> 0:09:18.760 I think one of the challenges that exist is how 0:09:18.800 --> 0:09:22.000 do we reassure patients who are dealing with an acute 0:09:22.040 --> 0:09:26.160 unexpected illness or those that are continuing to seek treatment 0:09:26.200 --> 0:09:30.079 for chronic, longstanding medical conditions that they need to connect 0:09:30.120 --> 0:09:33.000 with their care teams, with their clinicians, whether in the 0:09:33.040 --> 0:09:35.959 outpatient setting or elsewhere, to make sure that they're getting 0:09:35.960 --> 0:09:39.400 the care that they need. For quite a while, patients 0:09:39.440 --> 0:09:42.480 at a much greater weight than we would otherwise want, 0:09:42.920 --> 0:09:46.960 we're putting off or potentially foregoing care, delaying care. Um. 0:09:47.000 --> 0:09:49.360 I think it's long pass ado that we need to 0:09:49.360 --> 0:09:52.240 make sure that patients with chronic illnesses receive all of 0:09:52.240 --> 0:09:55.000 the on getting care that they need and again be 0:09:55.160 --> 0:09:58.720 prepared in the clinic setting to be responsive to people 0:09:58.760 --> 0:10:02.240 who have acute EXAs, asturbations of longstanding medical conditions, or 0:10:02.320 --> 0:10:05.360 something altogether new. And for those peoples that need to 0:10:05.400 --> 0:10:08.199 go to the emergency department understanding it's a safe place, 0:10:08.280 --> 0:10:11.440 they should not hesitate to call nine C E M. 0:10:11.520 --> 0:10:14.840 S Services when getting to the emergency department. The capacity 0:10:14.880 --> 0:10:16.240 you said is back to where it needs to be. 0:10:16.240 --> 0:10:18.680 What about utilization though, That's what I'm curious about. Where 0:10:18.720 --> 0:10:22.400 patients are actually tapping hospitals. How much down is that 0:10:22.559 --> 0:10:26.920 from pre pandemic levels. We still across the United States, 0:10:26.920 --> 0:10:28.520 and I would say in our health system are seeing 0:10:28.600 --> 0:10:31.719 lower rates of using utilizing our emergency departments that we 0:10:31.760 --> 0:10:35.400 would otherwise like. UM, so we know that there is 0:10:35.440 --> 0:10:39.000 a capacity that exceeds what is being utilized at least 0:10:39.080 --> 0:10:42.920 comparing that to pre pandemic levels going back prior to 0:10:43.040 --> 0:10:46.680 March of and so we know that there are more 0:10:46.720 --> 0:10:50.240 people out there who need our services that are actually 0:10:50.360 --> 0:10:54.880 utilizing it. Unrelated to COVID nineteen and so. Uh, it's 0:10:55.000 --> 0:10:58.679 opportunities like this to re affirm to patients that they 0:10:58.720 --> 0:11:01.880 should feel very comfortab able seeking the care that they need. 0:11:01.920 --> 0:11:05.960 That's true in our clinics. It does vary across different conditions, 0:11:06.000 --> 0:11:10.040 But regardless of the condition, regardless of the chronicity or 0:11:10.080 --> 0:11:13.040 acuity of their condition, we have the capacity and the 0:11:13.080 --> 0:11:15.679 ability to be able to help take care of you. So, 0:11:15.920 --> 0:11:17.880 because we have you here, I've got to ask you, 0:11:17.920 --> 0:11:20.400 what are you seeing in terms of COVID cases right now? 0:11:22.040 --> 0:11:24.679 So we're seeing upticks. I'm out in Portland, Oregon, and 0:11:24.720 --> 0:11:28.200 we're seeing an uptick overall compared to where we have been. 0:11:28.760 --> 0:11:32.559 I think it's reflective of several parts of the country, UM, 0:11:32.800 --> 0:11:36.960 in our communities UM. And it is disconcerting. UM. And 0:11:37.320 --> 0:11:40.040 I think for many of us, we thought we would 0:11:40.080 --> 0:11:42.240 we be well behind this, whether we're in the clinical 0:11:42.320 --> 0:11:45.640 community or not. UM, it's very disheartening to see the 0:11:45.760 --> 0:11:50.800 rising cases and rising hospitalization rates. And while it's a 0:11:50.920 --> 0:11:53.600 rate that is UH and an ability to be able 0:11:53.640 --> 0:11:56.080 to tackle it that's much better equipped than we were 0:11:57.040 --> 0:12:00.640 a year ago and earlier. UM, I would say, it's 0:12:00.720 --> 0:12:04.000 still is challenging for those of us who thought we'd 0:12:04.000 --> 0:12:05.720 be in a much better place than we are today. 0:12:06.000 --> 0:12:08.760 Is it typically younger? Is it people who are unvaccinated, 0:12:08.800 --> 0:12:10.800 which is certainly some of the stories that we've done 0:12:10.880 --> 0:12:13.040 a lot here at Bloomberg is that the trends that 0:12:13.080 --> 0:12:16.920 you're seeing, we're continuing to see that individuals who are 0:12:17.000 --> 0:12:21.520 who have not been vaccinated disproportionately represent individuals who are 0:12:21.520 --> 0:12:26.480 coming down with COVID nineteen and certainly requiring hospitalizations as well. UM. 0:12:26.520 --> 0:12:29.200 And I think this is again a reaffirmation of the 0:12:29.280 --> 0:12:33.760 importance of vaccination as the single most important individual tactic 0:12:33.800 --> 0:12:37.199 to help prevent severe illness and illness in general. Are 0:12:37.240 --> 0:12:41.160 you seeing as a result in uptick in vaccinations um 0:12:41.200 --> 0:12:44.679 as a result of the rise in delta cases once again, 0:12:46.200 --> 0:12:49.600 so we've been fortunate Oregon to at least succeed what 0:12:49.679 --> 0:12:52.720 the national average has been in terms of vaccination. That 0:12:52.840 --> 0:12:56.400 being said, there's always room for improvement, and so we 0:12:56.440 --> 0:13:01.760 continue to reinforce pretty emphatically the importance of getting vaccinated 0:13:02.559 --> 0:13:05.920 for all individuals who are eligible. UH. It is a 0:13:06.000 --> 0:13:09.760 key tactic to be able to help mitigate the risk 0:13:09.800 --> 0:13:13.080 of consequences. And for those of us who have been 0:13:13.120 --> 0:13:17.040 at this for an excess of fifteen months, it is 0:13:17.160 --> 0:13:21.840 extraordinarily disheartening to see individuals with severe illness or ultimately 0:13:21.960 --> 0:13:25.080 succumbing to something that is ultimately preventable. And I have 0:13:25.160 --> 0:13:28.960 to say within my sphere of friends and family and colleagues, 0:13:29.000 --> 0:13:30.679 I mean I do know people who have had some 0:13:30.800 --> 0:13:34.960 really difficult illnesses and have gotten incredible care throughout the 0:13:34.960 --> 0:13:38.120 pandemic um and just and didn't put things off and 0:13:38.400 --> 0:13:40.920 couldn't it was really kind of a life and death issue. 0:13:41.360 --> 0:13:45.240 Having said that, you know, remind our audience that's something 0:13:45.280 --> 0:13:49.560 that can be in the early stages or something that 0:13:49.679 --> 0:13:53.160 is manageable, how quickly it can become a much more 0:13:53.160 --> 0:13:56.280 difficult health situation and really quickly, I mean not you 0:13:56.360 --> 0:14:01.080 speaking quickly, but how the situation get involved very quickly. Absolutely, 0:14:01.120 --> 0:14:04.160 and so people can go from a relatively stable state 0:14:04.240 --> 0:14:07.640 to one being very decompensated very quickly. And our range 0:14:07.640 --> 0:14:11.600 of therapeutic options therapies that we have available have significantly 0:14:11.640 --> 0:14:13.920 improved compared to where we were more than a year ago. 0:14:14.440 --> 0:14:17.960 So for those individuals that have been infected with stars 0:14:17.960 --> 0:14:21.320 SCOBE two who have developed COVID nineteen, seeking medical attention 0:14:21.360 --> 0:14:23.680 as soon as possible is of key importance because our 0:14:23.800 --> 0:14:27.640 range of therapies are much greater than what we had 0:14:27.880 --> 0:14:30.240 more than a year ago. I think the second thing 0:14:30.280 --> 0:14:33.240 is just to reaffirm that for all individuals who are eligible. 0:14:33.320 --> 0:14:36.920 Vaccination is a key importance, and I would say to 0:14:36.960 --> 0:14:40.280 all of my clinical colleagues across the United States and elsewhere, 0:14:40.800 --> 0:14:43.760 UM I spend each day when I'm in clinic asking 0:14:43.800 --> 0:14:46.280 each patient about whether or not they've been vaccinated for 0:14:46.320 --> 0:14:49.680 those that are eligible, and really, at least under Betty, 0:14:49.720 --> 0:14:53.280 getting a better understanding of why people may be resistant. 0:14:53.280 --> 0:14:55.680 I think for those of us that are in the 0:14:55.720 --> 0:14:59.520 clinical community, we are often amongst the most trusted individuals 0:14:59.560 --> 0:15:02.280 when work with our patients and loved ones, and they 0:15:02.280 --> 0:15:04.440 are more likely to listen to us, perhaps than others, 0:15:04.520 --> 0:15:07.640 and so we play a key role in helping to 0:15:07.640 --> 0:15:11.360 help patients and their loved ones understand why if there 0:15:11.400 --> 0:15:15.880 are misgivings or uncertainty about getting vaccinated, how some of 0:15:15.960 --> 0:15:19.560 the concerns can be addressed through just discussion talk and 0:15:19.600 --> 0:15:22.600 making sure they understand where we're coming from. We understand 0:15:22.640 --> 0:15:27.920 where they're coming from and why we're advocating strongly for vaccination. So, 0:15:28.520 --> 0:15:31.280 just as we wrap up, I wonder Dr Gluckman, if 0:15:31.400 --> 0:15:35.560 you have any confidence in terms of the visibility of 0:15:35.560 --> 0:15:38.440 where we are six months from now or twelve months 0:15:38.440 --> 0:15:42.560 from now when it comes to the pandemic and kind 0:15:42.560 --> 0:15:45.480 of getting back to quote unquote normal, although I don't 0:15:45.520 --> 0:15:47.160 think it's it's going to be a new normal, right 0:15:47.160 --> 0:15:51.920 because we've lived through so much. Yeah, I think unfortunately, 0:15:51.960 --> 0:15:54.160 this is going to be with us for a while. 0:15:54.560 --> 0:15:57.080 And my hope is that the case rates continue to fall. 0:15:57.160 --> 0:16:01.280 But getting vaccinated to to gave the risk of new 0:16:01.400 --> 0:16:04.400 variants developing is going to be of key importance. The 0:16:04.480 --> 0:16:06.280 other thing I would say is a key takeaway is 0:16:06.320 --> 0:16:09.200 for those of us that work within health systems, you know, 0:16:09.440 --> 0:16:11.600 never in my lifetime would I ever have expected, nor 0:16:11.640 --> 0:16:14.200 have ever experienced anything like this. And so how do 0:16:14.280 --> 0:16:18.840 we prevent the next pandemic, the next major medical problem 0:16:19.160 --> 0:16:22.080 that does occur. How do we make sure we're well prepared, 0:16:22.440 --> 0:16:26.440 that we as a health care system communicate very clearly 0:16:26.520 --> 0:16:30.000 too at risk individuals to patients what is important, so 0:16:30.040 --> 0:16:32.760 we don't see the direct consequences as a result of 0:16:32.760 --> 0:16:37.000 the pandemic and infection, but also as our study sought 0:16:37.040 --> 0:16:42.200 to evaluate the indirect consequences, the secondary or carryover effects 0:16:42.240 --> 0:16:47.200 as a result of fear uncertainty, making sure that health systems, hospitals, 0:16:47.240 --> 0:16:50.320 emergency departments, clinics are safe places and that we're well 0:16:50.320 --> 0:16:53.200 prepared to take care of patients regardless. Have you guys 0:16:53.200 --> 0:16:56.840 at Providence St. Joseph Health, have you guys taken specific 0:16:56.880 --> 0:17:01.520 steps so that you're ready next time around? Continue much 0:17:01.600 --> 0:17:04.840 like we're in the surge today, to go through innumerable 0:17:04.880 --> 0:17:08.440 steps to make sure we're well prepared with multiple redundancies. 0:17:08.680 --> 0:17:10.640 And I really want to credit our leadership in our 0:17:10.760 --> 0:17:14.879 organization who has done a superbly stellar job of making 0:17:14.880 --> 0:17:19.800 sure that we are well prepared for additional waves should 0:17:19.840 --> 0:17:23.000 they occur, as well as the next pandemic. We spend 0:17:23.000 --> 0:17:25.840 a lot of time preparing for this, for other types 0:17:26.040 --> 0:17:30.719 of disasters, whether they be natural, whether they be infectious. UM. 0:17:30.760 --> 0:17:33.080 It doesn't take anything away from the fact that we 0:17:33.119 --> 0:17:36.280 continue as a health care system to struggle with the 0:17:36.920 --> 0:17:40.479 toll of just this being such a long lasting UH 0:17:40.640 --> 0:17:44.600 seeming like it has never ended UH events. But nonetheless, 0:17:44.640 --> 0:17:47.800 we will get through this UH. And importantly, we want 0:17:47.840 --> 0:17:49.960 to make sure that all of our patients stay safe 0:17:50.080 --> 0:17:52.640 as much as possible, as we continue to make the 0:17:52.640 --> 0:17:56.080 therapies available, as we continue to address non COVID night 0:17:56.119 --> 0:17:59.520 team related illness along with that related to the infection 0:17:59.560 --> 0:18:02.000 as well. Well. Listen, thank you so much for all 0:18:02.080 --> 0:18:03.840 this time today. We really covered a lot of ground 0:18:03.840 --> 0:18:06.960 and I really appreciate it and gave our listeners and 0:18:07.040 --> 0:18:09.720 viewers on YouTube a lot to think about. Dr ty Gluckman, 0:18:09.760 --> 0:18:12.080 thank you, and be well and stay safe. He's director 0:18:12.080 --> 0:18:16.119 of the Center for Cardiovascular Analytics at Providence St. Joseph Health. 0:18:16.160 --> 0:18:17.920 It's a massive system. He joined us on the phone 0:18:17.920 --> 0:18:21.480 from Portland, Oregon, talking about those who are not necessarily 0:18:21.480 --> 0:18:24.159 getting the care they need, also giving us an update 0:18:24.200 --> 0:18:27.320 on the COVID cases that they are specifically seeing. This 0:18:27.600 --> 0:18:31.400 is Bloomberg Business Week with Carol Masser and Bloomberg Quick 0:18:31.400 --> 0:18:35.119 Takes Tim Stenovic on Bloomberg Radio. All right, there's a 0:18:35.119 --> 0:18:36.919 lot of news on the political front today. It's not 0:18:36.960 --> 0:18:39.440 just about the resignation of New York Governor Andrew Cromo, 0:18:39.520 --> 0:18:41.840 which we have been covering here at Bloomberg. Is also, 0:18:41.880 --> 0:18:44.000 of course news out of the nation's capital, the Senate 0:18:44.040 --> 0:18:47.320 passing that more than half a trillion dollar infrastructure plan. 0:18:47.359 --> 0:18:50.960 It would represent, as I said, a massive burst of spending, 0:18:51.240 --> 0:18:54.760 the largest that we've seen on a federal level in decades, 0:18:54.840 --> 0:18:56.560 and it would be a pretty big, big victory for 0:18:56.720 --> 0:19:00.440 President Biden. In his economic agenda. So let's are with 0:19:00.600 --> 0:19:05.040 that infrastructure passage. Bloomberg News Congression Attacks reporter Laura Davison 0:19:05.359 --> 0:19:08.880 is up on Capitol Hill in d C. Laura, good 0:19:08.880 --> 0:19:11.400 to have you here. It it was a major step forward, 0:19:11.440 --> 0:19:14.760 but it ain't done yet, right, correct? It is. The 0:19:15.280 --> 0:19:17.520 bill has the Senate. The infrastructure bill has passed, but 0:19:17.520 --> 0:19:19.840 they've already started work on the budget resolution. This is 0:19:19.840 --> 0:19:22.960 the three point five trillion dollar bill. Uh, that will 0:19:23.280 --> 0:19:25.960 kind of complete the rest of Joe Biden's agenda. So 0:19:26.000 --> 0:19:28.520 they did sort of the roads and bridges proportion earlier today, 0:19:28.800 --> 0:19:31.200 and now they're beginning, uh, the second portion, which is 0:19:31.240 --> 0:19:34.679 looking at kind of that suck infrastructure investments into healthcare, 0:19:34.800 --> 0:19:37.960 into education and childcare, um and as well as a 0:19:37.960 --> 0:19:42.720 whole bunch of climate change preventing uh different mechanisms as well. Yeah, 0:19:42.760 --> 0:19:44.399 it's massive in terms of spending. Hey, you know, I 0:19:44.440 --> 0:19:46.040 wanted to ask you though, before we got into a 0:19:46.080 --> 0:19:48.560 little bit more of the particulars about what's next in 0:19:48.640 --> 0:19:52.639 terms of this process for infrastructure spending. Is what's everyone 0:19:52.680 --> 0:19:55.320 talking about up on Capitol Hill? Is it about infrastructure 0:19:55.400 --> 0:19:58.879 or is it about the resignation of Governor Cuomo. No 0:19:59.040 --> 0:20:01.400 today has really been and um, a lot a lot 0:20:01.600 --> 0:20:05.240 of of of infrastructure, you know, Cuomo, certainly this was 0:20:05.440 --> 0:20:07.280 news in convery went by a little bit of surprise, 0:20:07.720 --> 0:20:10.560 but though really every major Democrat in the country had 0:20:10.600 --> 0:20:13.359 already called for his resignation, so this was more of 0:20:13.440 --> 0:20:15.959 a um, you know, kind of seeing that happen and 0:20:16.000 --> 0:20:19.159 now moving on. I think Democrats in particular are you know, 0:20:19.200 --> 0:20:21.320 looking to focus on their policy wins and maybe not 0:20:21.359 --> 0:20:23.679 so much on the scandals and the party well. And 0:20:23.720 --> 0:20:26.200 it's interesting though, but you know this better than most 0:20:26.400 --> 0:20:29.920 that when there's somebody who is very well known within 0:20:29.960 --> 0:20:33.800 the political party, uh a face of the political party 0:20:33.880 --> 0:20:36.119 in many ways, or very outspoken, and when you think 0:20:36.160 --> 0:20:40.199 about you know, prominent Democrats, certainly Andrew Como because of 0:20:40.240 --> 0:20:43.160 his family legacy, because of him he and his own 0:20:43.320 --> 0:20:46.080 you know, involvement in government on a federal level and 0:20:46.160 --> 0:20:49.240 of course in the New York state level. You know, 0:20:49.320 --> 0:20:51.520 you do wonder about what are the implications for the 0:20:51.560 --> 0:20:54.680 party or for a current administration. Are there any connections 0:20:55.119 --> 0:20:57.920 that can be made that makes you know, some Democrats 0:20:57.960 --> 0:21:01.320 a little bit nervous or not necessarily you know, it's 0:21:01.400 --> 0:21:03.920 it's not a huge issue, but you really do see, um, 0:21:03.920 --> 0:21:05.959 you know, kind of this issue has something that has 0:21:05.960 --> 0:21:08.760 been kind of dog Democrats of how did they address um, 0:21:08.800 --> 0:21:10.439 you know, kind of how women are treated. And then 0:21:10.440 --> 0:21:14.159 the whole New Too movement. If we saw um Al Frankin, 0:21:14.520 --> 0:21:17.359 senator from Minnesota get pushed out by members of his 0:21:17.400 --> 0:21:19.920 own party several years ago. Um, and I think the 0:21:19.920 --> 0:21:22.040 the party maybe felt, uh, some people felt like they 0:21:22.080 --> 0:21:24.240 maybe moved a little too quickly and didn't fully examine 0:21:24.240 --> 0:21:27.080 the situation there. Um. But with with Cuomo, it was 0:21:27.160 --> 0:21:29.000 like a little bit more clear the path forward and 0:21:29.000 --> 0:21:31.640 that uh that really that the once that report came out. 0:21:31.640 --> 0:21:33.439 That but he really didn't have anyone backing him, and 0:21:33.440 --> 0:21:35.359 that was a clear decision for Democrats to make. Because 0:21:35.440 --> 0:21:37.399 New York of course a big and important state, no 0:21:37.480 --> 0:21:41.440 doubt about it for the Democrats going forward, this new 0:21:41.440 --> 0:21:44.800 governor coming in, uh, the deputy governor, how does that 0:21:44.880 --> 0:21:50.000 change in terms of collaborations working together on a federal 0:21:50.000 --> 0:21:53.760 and state level. Well, you know, you cool had really 0:21:53.760 --> 0:21:56.159 been sort of a a leader both policy wise on 0:21:56.359 --> 0:22:00.560 COVID response with kind of the theig new governor coming in, Um, 0:22:00.720 --> 0:22:02.520 she's really going to be more holding down the porch 0:22:02.640 --> 0:22:04.200 than sort of being a leader. She's just trying to 0:22:04.240 --> 0:22:06.760 kind of keep the ship on track. Um, for New 0:22:06.840 --> 0:22:10.720 York may find its influence over policy debates a little 0:22:10.720 --> 0:22:12.560